Plasmaferese : veilig bij een goede indicatiestelling en kennis van de complicaties [Plasmapheresis, a safe treatment when applied to the correct indication and with awareness of the complications]

Plasmapheresis is an extracorporeal technique used to remove pathogenic macromolecules from the circulation, particularly autoantibodies. This is illustrated in 2 female patients. The first patient, aged 61 years, was treated successfully with non-selective plasmapheresis for acute humoral rejection shortly after receiving a renal allograft. In the second patient, aged 82 years, plasmapheresis for refractory myasthenia gravis had to be stopped because of bradycardia and hypotension during the procedure. She was treated successfully with immunoglobulins. Plasmapheresis is used to treat neurological, renal, haematological and systemic disorders. In nonselective plasmapheresis, the plasma is replaced with saline and albumin or donor plasma. In selective plasmapheresis a highly selective filter is used to remove a specific, pathogenic macromolecule. Adverse effects of the treatment include disturbances of the acid-base equilibrium or the coagulation, and allergic reactions. Most of these complications, however, can nowadays be avoided.

Awareness of HIV Testing Guidelines Is Low among Swiss Emergency Doctors: A Survey of Five Teaching Hospitals in French-Speaking Switzerland.

BACKGROUND: In Switzerland, 30% of HIV-infected individuals are diagnosed late. To optimize HIV testing, the Swiss Federal Office of Public Health (FOPH) updated 'Provider Induced Counseling and Testing' (PICT) recommendations in 2010. These permit doctors to test patients if HIV infection is suspected, without explicit consent or pre-test counseling; patients should nonetheless be informed that testing will be performed. We examined awareness of these updated recommendations among emergency department (ED) doctors. METHODS: We conducted a questionnaire-based survey among 167 ED doctors at five teaching hospitals in French-Speaking Switzerland between 1(st) May and 31(st) July 2011. For 25 clinical scenarios, participants had to state whether HIV testing was indicated or whether patient consent or pre-test counseling was required. We asked how many HIV tests participants had requested in the previous month, and whether they were aware of the FOPH testing recommendations. RESULTS: 144/167 doctors (88%) returned the questionnaire. Median postgraduate experience was 6.5 years (interquartile range [IQR] 3; 12). Mean percentage of correct answers was 59 ± 11%, senior doctors scoring higher (P=0.001). Lowest-scoring questions pertained to acute HIV infection and scenarios where patient consent was not required. Median number of test requests was 1 (IQR 0-2, range 0-10). Only 26/144 (18%) of participants were aware of the updated FOPH recommendations. Those aware had higher scores (P=0.001) but did not perform more HIV tests. CONCLUSIONS: Swiss ED doctors are not aware of the national HIV testing recommendations and rarely perform HIV tests. Improved recommendation dissemination and adherence is required if ED doctors are to contribute to earlier HIV diagnoses.

The environmental roots of non-communicable diseases (NCDs) and the epigenetic impacts of globalization

BACKGROUND: Non-communicable diseases (NCDs) are increasing worldwide. We hypothesize that environmental factors (including social adversity, diet, lack of physical activity and pollution) can become "embedded" in the biology of humans. We also hypothesize that the "embedding" partly occurs because of epigenetic changes, i.e., durable changes in gene expression patterns. Our concern is that once such factors have a foundation in human biology, they can affect human health (including NCDs) over a long period of time and across generations. OBJECTIVES: To analyze how worldwide changes in movements of goods, persons and lifestyles (globalization) may affect the "epigenetic landscape" of populations and through this have an impact on NCDs. We provide examples of such changes and effects by discussing the potential epigenetic impact of socio-economic status, migration, and diet, as well as the impact of environmental factors influencing trends in age at puberty. DISCUSSION: The study of durable changes in epigenetic patterns has the potential to influence policy and practice; for example, by enabling stratification of populations into those who could particularly benefit from early interventions to prevent NCDs, or by demonstrating mechanisms through which environmental factors influence disease risk, thus providing compelling evidence for policy makers, companies and the civil society at large. The current debate on the '25 × 25 strategy', a goal of 25% reduction in relative mortality from NCDs by 2025, makes the proposed approach even more timely. CONCLUSIONS: Epigenetic modifications related to globalization may crucially contribute to explain current and future patterns of NCDs, and thus deserve attention from environmental researchers, public health experts, policy makers, and concerned citizens.

The enterprise face to the environmental challenge: straddling the fence between social responsibility and penal responsibility

This contribution aims to analyse how to incur companies' criminal liability when they violate environmental protection globally. In Switzerland, companies' criminal liability has already been provided for to fight against money launder- ing (Article 102 CP). Could a similar liability be incurred, in Switzerland, for companies that infringe environmental protection? This is what our contribution is all about. Since the company is at the heart of our subject, the point is to see to what extent criminal liability could be transposed to cases of violation by companies of the environmental principles promoted by the CSR concept.

A comparison of alpha and gamma spectrometry for environmental natural radioactivity surveys.

An alpha-spectrometry, using automated borate fusion and sequential extraction and exchange chromatography, was used to determine the uranium and thorium based on environmental radioactivity of 20 soil samples. The same set of the samples was analysed using gamma-spectrometry with an HPGe detector. The two data sets were checked for coherence using Z-score and chi2 statistical tests. We show that gamma-spectrometry is a valid alternative to time-consuming alpha-spectrometry for the determination of natural uranium and thorium activity in soil (activity range: 12.5-58.2 Bq/kg). The measured activities were compared with the theoretical activities to ensure secular equilibrium in the 238U and 232Th series. For 226Ra, a special study was made on deconvolution of the 186 keV multiplet with the Levenberg-Marquardt algorithm. Finally, the combined use of Z-score and chi2-tests was found to be a powerful tool for comparing the results obtained with two different methods.

Genetic variation and environmental effects on beta-conglycinin and glycinin content in Brazilian soybean cultivars

The objective of this work was to determine genetic and environmental effects on beta-conglycinin and glycinin content in Brazilian soybean cultivars. The concentrations of these protein fractions were analyzed by scanning densitometry after electrophoresis, in 90 Brazilian soybean cultivars sown in Ponta Grossa, PR, in 2001. The effects of the sowing location were determined in the cultivar MG/BR 46 (Conquista), sown in 16 locations of Goiás and Minas Gerais states (Central Brazil), and in the cultivar IAS 5, sown in 12 locations of Paraná and São Paulo states (Southern Brazil), in 2002 soybean season. A significant variability for beta-conglycinin (7S) and glycinin (11S) protein fractions ratio was observed among the 90 Brazilian soybean cultivars. 'MS/BRS 169' (Bacuri) and 'BR-8' (Pelotas) presented the highest and the lowest 11S/7S ratios (2.76 and 1.17, respectively). Beta-conglycinin protein fractions presented more variability than glycinin protein fractions. Grouping test classified 7S proteins in seven groups, 11S proteins in four groups, and protein fraction ratios (11S/7S) in nine groups. Significant effect of sowing locations was also observed on protein fractions contents. There is a good possibility of breeding for individual protein fractions, and their subunits, without affecting protein content.

East 1 St Street Interchange and I-35 Widening, From MP 94.3 to Oralabor Road, Polk County, Iowa, Project # IM-035-4(140)92--13-77, Environmental Assessment and Section 4(f) De Minimis Impact Finding, 2015

From Proposed Action: "The proposed action consists of reconstructing the East 1st Street/I-35 interchange with a Diverging Diamond interchange, widening I-35 from four (4) lanes to six (6) lanes, and widening East 1st Street from four (4) lanes to five (5) lanes from Delaware Avenue to Frisk Drive. The project also proposes to reconstruct the intersections of East 1st Street/Creekview Drive and East 1st Street/Frisk Drive."

West 1 St Street/ IA 57 from Highland Drive to Center Street/Franklin Street, Blackhawk County, Iowa, Project # STP-57-2(28)--2C-07, Environmental Assessment and Section 4(f) De Minimis Impact Finding, 2015

From Proposed Action: "Iowa Northland Regional Council of Governments (INRCOG) and the City of Cedar Falls, in coordination with the Iowa Department of Transportation (Iowa DOT) and the Federal Highway Administration (FHWA), are proposing to upgrade and modernize an approximate 4,900-foot segment of Iowa Highway 57 (IA 57), locally known as West 1st Street, in Cedar Falls, Black Hawk County, Iowa."

Enhancing Motorcycle Conspicuity Awareness in Iowa, 2010

Previous studies in the United States and internationally suggest that low motorcycle conspicuity, or the inability of the motorcyclist to be seen by other road users, is thought to be an important factor associated with risk of motorcycle crashes. However, there has been limited research on motorcycle conspicuity in the United States in the past two decades, while at the same time; there has been a renewed interest from states in increasing motorcycle conspicuity and motorist awareness. As such, this research revisits the motorcycle conspicuity problem by analysis of helmet-use and motorcycle crash data. First, this study reviews previous studies on motorcycle conspicuity with a focus on the effectiveness of proposed measures for enhancing motorcycle conspicuity. The major trends in motorcycle helmet use by time of day and road type for motorcyclists, as indicated from three roadside observational roadside surveys in Iowa, are also discussed. Then, using motorcycle crash data for Iowa from 2001 to 2008, this research compares single-and two-vehicle motorcycle crashes and examines the distribution of conspicuity related factors in light and dark conditions in two-vehicle crashes that could potentially relate to a collision between a motorcycle and another vehicle. The limitations of examining motorcycle conspicuity by analysis of crash data are also discussed. Finally, this report outlines recommendations based on the key findings of the study.

Combining ability of maize grain yield under different levels of environmental stress

The objectives of this work were to caracterize the tropical maize germplasm and to compare the combining abilities of maize grain yield under different levels of environmental stress. A diallel was performed among tropical maize cultivars with wide adaptability, whose hybrid combinations were evaluated in two sowing dates, in two years. The significance of the environmental effect emphasized the environmental contrasts. Based on grain yield, the environments were classified as favorable (8,331 kg ha-1), low stress (6,637 kg ha-1), high stress (5,495 kg ha-1), and intense stress (2,443 kg ha-1). None of the genetic effects were significant in favorable and intense stress environments, indicating that there was low germplasm variability under these conditions. In low and high stresses, the specific combining ability effects (SCA) were significant, showing that the nonadditive genetic effects were the most important, and that it is possible to select parent pairs with breeding potential. SCA and grain yield showed significant correlations only between the closer environment pairs like favorable/low stress and high/intense stress. The genetic control of grain yield differed under contrasting stress environments for which maize cultivars with wide adaptability are not adequate.

Environmental and genetic variation of isoflavone content of soybean seeds grown in Brazil

The objective of this work was to evaluate isoflavone concentrations in seeds of different Brazilian soybean cultivars grown in a range of locations and environmental conditions in Brazil. Seeds of 233 cultivars grown in Ponta Grossa, PR, Brazil, during the 2001/2002 soybean season, and of 22 cultivars sown in different locations of Brazilian Northeast, Southeast on South regions were analyzed for total isoflavones, including daidzin, glycitin, genistin and acetylgenistin. The total isoflavones ranged from 12 mg 100 g-1 (cv. Embrapa 48) to 461 mg 100 g-1 (cv. CS 305) among the 233 cultivars grown in Ponta Grossa, and the differences among them are due to genetic effects since all cultivars were grown and collected at the same locatation and year. This is an indication of the possibility of breeding for isoflavone content. Differences in isoflavone content observed in the cultivars grown in different locations permit the selection of locations for optimum isoflavone content (low or high), depending on the uses of soybean. In the Northeast region (5-8°S), higher concentrations of total isoflavones were observed at São Raimundo das Mangabeiras (232 mg 100 g-1) and Tasso Fragoso (284 mg 100 g-1) municipalities, and in the South (23-30°S), isoflavones were higher in Guarapuava, Canoinhas, Vacaria and Campos Novos municipalities, ranging from 130 to 409 mg 100 g-1.

Access Management Research and Awareness Program : Phase IV, 1999

Access management involves balancing the dual roles that roadways must play - through travel and access to property and economic activity. When these roles are not in proper balance, the result is a roadway system that functions sub-optimally. Arterial routes that have a too high driveway density and provide overly extensive access to property have high crash rates and begin to suffer in terms of traffic operations. Such routes become congested, delays increase, and mean travel speeds decline. The Iowa access management research and awareness project has had four distinct phases. Phase I involved a detailed review of the extensive national access management literature so lessons learned elsewhere could be applied in Iowa. In Phase II original case study research was conducted in Iowa. Phase III of the project concentrated on outreach and education about access management. Phase IV of the Iowa access management project extended the work conducted during Phases II and III. The main work products for Phase IV were as follows: 1) three additional before and after case studies, illustrating the impacts of various access management treatments on traffic safety, traffic operations, and business vitality; 2) an access management handbook aimed primarily at local governments in Iowa; 3) a modular access management toolkit with brief descriptions of various access management treatments and considerations; and 4) an extensive outreach plan aimed at getting the results of Phases I through IV of the project out to diverse audiences in Iowa and elsewhere.